Toxoplasma gondii infection is associated with changes in chronic outcomes in traumatic brain injury.

Alcohol Use Disorder (AUD) is a “problematic pattern of alcohol use leading to clinically significant impairment or distress, manifested by at least two criteria occurring within a 12-month period; including feeling a strong urge to use alcohol, failure to cut down alcohol use, consuming more alcohol than intended, failure to fulfill other life obligations, spending a lot of time to obtain, and using or recovering from alcohol” (DSM 5). Globally, over 400 million (7%) people were affected [, ]. In Sub-Saharan Africa, about 2.4% of all deaths and 2.1% of disability-adjusted life years (DALYs) were related to AUD []. In Rwanda, the estimated AUD prevalence was 7%, toward the upper end of regional estimates [, ]. As national alcohol consumption rose from 41% in 2013 to 48% in 2022, the AUD burden is likely to grow if these trends continue []. This rise likely reflects a combination of social, economic, biological, and cultural factors. Alcohol use disorder (AUD) arises from a mix of social and biological risk factors, with genetics accounting for about 50% of the risk to develop AUD [], []. Co-occurring mental health conditions such as mood disorder, schizophrenia, and personality disorders further elevate the risk and complicate care [–]. AUD disrupts work, family life, and financial wellbeing. It also increases the risk of chronic diseases and injuries. AUD contributes markedly to the global burden of disease by 5.1%, including 2,6 millions of deaths and a large share of DALYs worldwide by 8.9% [–]. However, treatment interventions are effective. Effective treatment often combines pharmacological and psychosocial interventions yet cost limits service availability. Uneven distribution of services among urban and rural settings, and gaps in primary care skills restrict access in low-resource settings [, ]. In sub-Saharan Africa, additional barriers include financial constraints, low awareness of the disorders and services, perceived poor quality of care, negative perceptions toward care, and sociocultural and physical obstacles to use [, , , ]. In Rwanda, studies have shown only 5.3% have accessed mental health services and only 6.1% of individuals with AUD sought professional help []. AUD screening is conducted during routine primary care visits at health centers, which represent the lower tier of Rwanda’s healthcare system. At this level, patients can access general outpatient mental health services, including psychotherapy.